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Recent Publications

“Prostate Cancer of High Risk is Increasing”

Apr 15, 2018

Epidemiologic evidence indicates that more men are now presenting with higher-grade, more invasive prostate cancer in the wake of 2012 recommendations from the US Preventive Services Task Force (USPSTF) not to routinely screen asymptomatic patients to detect early disease. There has been a consistent, stepwise increase in cancers of higher Gleason score, as well as a stepwise increase in the median level of prostatic-specific antigen (PSA), in the 4 years after the USPSTF recommendations were released. At the same time, both surgical volume and the proportion of low-grade cancers have been dropping. Experts say, “Treating high-risk disease has its limitations, because you are not going to cure the majority of patients no matter what you do, so the better answer is to diagnose prostate cancer earlier.” They also say, “If our data are correct, the most important thing to do is to start screening more intensely again.” According to the American Cancer Society (ACS), in the United States, there will be nearly 61,360 new cases of prostate cancer diagnosed this year and about 26,730 deaths from the disease.

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“Sinus Infections May Not Require Antibiotics”

Apr 08, 2018

Most people prescribed antibiotics for sinus infections are treated for 10 days or longer, even though infectious disease doctors recommend 5 to 7 days for uncomplicated cases. But, is this necessary or recommended? A sinus infection, called acute rhinosinusitis, is inflammation of the nasal and sinus passages that can cause uncomfortable pressure on either side of the nose and last for weeks. Most sinus infections develop during or after a cold or other upper respiratory infection, but other factors such as allergens and environmental irritants may play a role. Nearly one in seven people are diagnosed with a sinus infection each year. The vast majority of sinus infections are caused by viruses and should not be treated with antibiotics, suggest new guidelines released by the Infectious Diseases Society of America (IDSA) in 2012. Although sinus infections are the fifth leading reason for antibiotic prescriptions, 90 to 98 percent of cases are caused by viruses, which are not affected by antibiotics. Used inappropriately, antibiotics foster the development of drug-resistant superbugs. Common side effects of antibiotics can include rash, dizziness, nausea, diarrhea, and yeast infections. More serious side effects may include life-threatening allergic reactions and Clostridium difficile infection.

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“Bread, Health and a Slice of Confusion”

Apr 01, 2018

For decades, we have heard that whole grain bread is healthier than white bread. But, is this true? A new study reveals that there is no difference between the health effects of “wholesome” and white bread. Bread occupies a unique place in our diet: it accounts for about one–tenth of the calories many people in the West consume and up to 40% of the caloric consumption in some non–Western countries – more than any other food product. In the past few decades, since white bread has acquired a bad name, bakeries have been going out of their way to produce high–quality whole grain breads. But, a new study conducted at the Weizmann Institute of Science and published recently in the journal Cell Metabolism reveals that these “wholesome” choices are not necessarily the healthiest for everyone. Tests revealed that eating bread of any kind affected the blood levels of sugar, minerals, liver enzymes and other substances. But when the scientists compared the effects of the two types of bread, they were surprised. “We were sure that the sourdough bread would come out a healthier choice, but much to our surprise, we found no difference between the health effects of the two types of bread,” said Prof. Eran Segal of Weizmann Institute’s Computer Science and Applied Mathematics Department.

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“Burnout Suffered by 42% of Physicians”

Mar 25, 2018

A recent Medscape survey found that 42% of physicians report burnout. Physicians face “assembly-line medicine pressures,” merciless scheduling demands, battles with insurance companies, increasing regulations, and an explosion in scientific literature with which their knowledge must remain current. Their debt burdens often total hundreds of thousands of dollars, and they struggle in constant fear of malpractice suits. In medical school, professors teach their driven young students to put their own emotions aside, even as they attend to tragedy. A Mayo Clinic study showed an association between burnout and declining professional satisfaction with physicians reducing the number of hours they devote to clinical practice. Tragically, an even greater problem is the high rate of suicides amongst physicians and at least 400 doctors kill themselves annually, as of 2015. The current body of knowledge suggests burnout is driven by external factors, such as inefficient work processes, long work hours, heavy workloads, work–home conflicts, and organizational culture considerations. In 2018, 1,528 physicians at the Cleveland Clinic Health System were surveyed with the medical personnel version of the Maslach Burnout Inventory.

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“Heart Bypass Surgery Limitations”

Mar 18, 2018

Some patients may have placed a little false hope in long-term heart bypass surgery. In 2010, experts found, “The bypass operation did not improve survival for heart failure patients who already were taking medicines to control risks like high cholesterol and high blood pressure.” Doctors assumed bypass would cut deaths by 25 percent. But after nearly five years, the study of 1,200 heart failure patients showed that about the same number in each group had died. Actually, for the first two years, there were more deaths among those given surgery versus the others. In addition to the new knowledge about a “special period of attention” 8–10 years after the bypass surgery, the first month is particularly critical. Within the first 30 days after bypass surgery, patients have an increased risk of dying in connection with the operation, which is not in itself new. The survival rate for bypass patients who make it through the first month after the operation is close to that of the population in general. But, 8–10 years after a heart bypass operation, mortality increases by 60–80 percent. This is new and important knowledge for the doctors who monitor these patients. This is the main conclusion in 2017 of a comprehensive national register-based study that sheds light on the thirty–year prognosis following a heart bypass operation, on 51,000 Danish patients who had undergone surgery in the period 1980 – 2009.

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“Acid Reflux Drugs May Cause or Prevent Esophageal Cancer”

Mar 11, 2018

Heartburn or acid reflux (gastroesophageal reflux) affects about 20 percent of Americans. Millions of U.S. residents take proton pump inhibitors (PPIs), which include lansoprazole (Prevacid), and esomeprazole (Nexium) and omeprazole (Prilosec), both manufactured by AstraZeneca. Over-the-counter PPIs are most often used for heartburn and indigestion and many people end up taking the drugs for months or years. PPIs are some of the most widely prescribed drugs in the U.S., with $14 billion in annual sales. But, significant side effects have been reported with increasing frequency, such as alterations of absorption of vitamins and minerals, metabolic effects on bone density, alterations of drug interactions, alterations of intended effect, infection risk, hypersensitivity response with consequent organ damage, vitamin B12 deficiency and susceptibility to hip, wrist or spinal fractures, increased the risk of heart attack, kidney failure, dementia and death. Because stomach acid kills bacteria, people who take PPIs are also more prone to foodborne infections, such as Salmonella. However, some authors are skeptical of some of the other reported side effects. Some of the reported side effects, such as vitamin B12 and iron deficiency (both of which ultimately result from a decrease in stomach acid), are real.

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“Alcohol Linked to Dementia”

Mar 04, 2018

Alcohol flows freely throughout the world. However, study after study is pointing to alcohol as being a cause of a variety of cancers. Furthermore, it is being discredited as having heart healthy benefits. It now appears that any reduction in alcohol consumption will lower the risk of cardiovascular diseases and cancer risk. But, health information campaigns are ineffective against the powerful marketing-forces pushing alcohol. As a public health issue, no one should be pushing and condoning the consumption of alcohol. Early in 2014, the United Kingdom issued new guidelines on alcohol drinking, recommending that men drink no more than women and warning that any amount of alcohol increases the risk of developing a range of cancers. A new 2018 study suggests heavy alcohol consumption is a major risk factor for all types of dementia, but particularly early-onset dementia. The retrospective analysis involving 30 million people in France shows that those with a history of alcohol use disorders had a threefold increased risk for dementia and that over half those with early-onset dementia had a history of alcohol problems. Dr. Michaël Schwarzinger, lead author said, “Our results suggest that heavy drinking is the strongest potentially modifiable risk factor for dementia that we have ever seen.

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“Marijuana 2018 Update”

Feb 25, 2018

The 2015 decision by the Obama administration not to enforce federal anti-marijuana laws marked a significant change and Americans have seen the growth of large, for-profit commercial enterprises that will saturate the country with “pot.” It is estimated that around 22.2 million people in the United States have used marijuana in the past month, making it “the most commonly used illicit drug” in the country. The National Institute on Drug Abuse summarized six salient points on marijuana entitled “Adverse Health Effects of Marijuana Use,” as follows: 1) marijuana is particularly harmful to children and youths under 21 years of age; 2) it can affect short-term memory; 3) it is associated with “significant declines in IQ” if used frequently when one is an adolescent or a young adult; 4) it impairs a person’s “motor coordination; 5) it is addictive. About 9 percent of users overall become addicted, but that number rises to 17 percent of those who start as adolescents and shoots up to as much as 50 percent among those who use pot daily; and 6) it is related to social ills. Today’s marijuana contains about four times as much THC, the ingredient that produces the “high,” than it did in the 1980s.

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“Healthy Balanced Diets May Be Hard To Find”

Feb 18, 2018

We are repeatedly told to eat a healthy balanced diet but who determines what is included in that diet? Opinions vary considerably, and it is difficult to find conclusive scientific verification of the ideal healthy balanced diet. A new study shows that a diet that includes a lot of highly processed foods loaded with sugar, fat, and salt may do more than raise the risk for overweight, obesity, type 2 diabetes, and heart disease. French investigators have found that highly processed foods such as packaged baked goods, instant soups, reconstituted meats, frozen meals, and shelf-stable snacks also contain substances that may significantly increase overall risk for cancer and breast cancer. But, a British expert said, “People shouldn’t worry about eating a bit of processed food here and there based on this study.” We are admonished to avoid “processed foods” that include mass-produced packaged breads and buns, sweet or savory packaged snacks, packaged confectionery and desserts, sodas, and sweetened drinks, meatballs, poultry and fish nuggets, and other reconstituted meat products using non-salt preservatives such as nitrites.

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“Daily Aspirin Therapy Can Be A Life Saver”

Feb 11, 2018

Aspirin is used across the globe to treat a number of health conditions, ranging from short-term pain relief to long-term prescriptions. Significant research has been done regarding aspirin use and prevention of cancer and heart attacks. Long-term aspirin use reduces the incidence of digestive cancers by up to 47%. Those prescribed with aspirin showed a 47% reduction in liver and esophageal cancer incidence, a 38% reduction in gastric cancer incidence, a 34% reduction in pancreatic cancer incidence and a 24% reduction in colorectal cancer incidence. The effect of long-term use of aspirin on cancer incidence was also examined for cancers outside of the digestive system. Here, a significant reduction was shown for some (leukemia, lung and prostate) but not all (breast, bladder, kidney and multiple myeloma) cancers. Although opinions differ, an analysis of previous clinical trials showed that people on aspirin were less likely to die of cancer than those not on the medication, with a 37-percent drop in cancer deaths observed from five years onwards.

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